MDedge Rheumatology

TOPLINE:

Treatment with biologic disease-modifying antirheumatic drugs (bDMARDs), particularly tocilizumab, can suppress inflammation and preserve renal function in a majority of patients with chronic inflammatory disorders who develop serum amyloid alpha (SAA) amyloidosis.

METHODOLOGY:

• AA amyloidosis, characterized by the misfolding of the SAA protein, is observed in patients with inflammatory diseases and can lead to progressive organ damage, including chronic kidney disease, malabsorption with cachexia, and cardiac failure.
• This monocentric, retrospective analysis assessed the effect of bDMARD therapy on inflammatory biomarker levels and renal outcomes in 83 patients with AA amyloidosis who were followed for a mean period of 4.82 years.
• The patients were stratified into three major subgroups depending on the cause of AA amyloidosis:
• Chronic inflammatory diseases (cid + AA; n = 34) such as rheumatoid arthritis, Crohn’s disease, and chronic infections
• Autoinflammatory syndromes (auto + AA; n = 24) such as familial Mediterranean fever (FMF) and cryopyrin-associated periodic syndrome (CAPS)
• Idiopathic AA (idio + AA; n = 25), wherein the primary disease could not be identified
• Tocilizumab was the most commonly used bDMARD in patients with cid + AA and idio + AA amyloidosis, and interleukin-1 inhibitors were prescribed to patients with auto + AA amyloidosis because tocilizumab has not been approved yet for FMF or CAPS treatment.
• All patients with AA amyloidosis had renal involvement, as confirmed by kidney biopsy.

TAKEAWAY:

• After bDMARD therapy, C-reactive protein levels reduced significantly from baseline to the last-documented visit in all subgroups, while SAA levels declined in the subgroups cid + AA and idio + AA and proteinuria dropped in the subgroups auto + AA and idio + AA.
• bDMARDs prevented progression to end-stage renal disease (ESRD) in 75% of the patients in the overall cohort, with progression to ESRD being prevented in 60% of patients with cid + AA, 88% of patients with auto + AA, and 81% of patients with idio + AA.
• Tocilizumab was more effective than other bDMARDs in preventing renal progression to ESRD (P = .0006), with a similar pattern observed for the subgroups cid + AA (P = .0126) and idio + AA (P = .0259).
• None of the patients receiving tocilizumab died during the nearly 5-year follow-up period.

IN PRACTICE:

“The data suggest preferential use of IL [interleukin]-1 inhibitors and tocilizumab for clinical use in the treatment of AA amyloidosis depending on the respective underlying diseases,” the authors wrote.

SOURCE:

This study, led by Peter Kvacskay, MD, of Heidelberg University Hospital, Heidelberg, Germany, was published online on April 23 in Annals of the Rheumatic Diseases.

LIMITATIONS:

Authors acknowledged the retrospective nature of the analysis and missing data of single patients during the long-term follow-up as major limitations. Furthermore, the cid + AA subgroup was heterogeneous in terms of the pathophysiology of their underlying primary disease.

DISCLOSURES:

This study did not report any source of funding. The authors declared no conflicts of interest.

A version of this article appeared on Medscape.com.

TOPLINE:

Treatment with biologic disease-modifying antirheumatic drugs (bDMARDs), particularly tocilizumab, can suppress inflammation and preserve renal function in a majority of patients with chronic inflammatory disorders who develop serum amyloid alpha (SAA) amyloidosis.

METHODOLOGY:

• AA amyloidosis, characterized by the misfolding of the SAA protein, is observed in patients with inflammatory diseases and can lead to progressive organ damage, including chronic kidney disease, malabsorption with cachexia, and cardiac failure.
• This monocentric, retrospective analysis assessed the effect of bDMARD therapy on inflammatory biomarker levels and renal outcomes in 83 patients with AA amyloidosis who were followed for a mean period of 4.82 years.
• The patients were stratified into three major subgroups depending on the cause of AA amyloidosis:
• Chronic inflammatory diseases (cid + AA; n = 34) such as rheumatoid arthritis, Crohn’s disease, and chronic infections
• Autoinflammatory syndromes (auto + AA; n = 24) such as familial Mediterranean fever (FMF) and cryopyrin-associated periodic syndrome (CAPS)
• Idiopathic AA (idio + AA; n = 25), wherein the primary disease could not be identified
• Tocilizumab was the most commonly used bDMARD in patients with cid + AA and idio + AA amyloidosis, and interleukin-1 inhibitors were prescribed to patients with auto + AA amyloidosis because tocilizumab has not been approved yet for FMF or CAPS treatment.
• All patients with AA amyloidosis had renal involvement, as confirmed by kidney biopsy.

TAKEAWAY:

• After bDMARD therapy, C-reactive protein levels reduced significantly from baseline to the last-documented visit in all subgroups, while SAA levels declined in the subgroups cid + AA and idio + AA and proteinuria dropped in the subgroups auto + AA and idio + AA.
• bDMARDs prevented progression to end-stage renal disease (ESRD) in 75% of the patients in the overall cohort, with progression to ESRD being prevented in 60% of patients with cid + AA, 88% of patients with auto + AA, and 81% of patients with idio + AA.
• Tocilizumab was more effective than other bDMARDs in preventing renal progression to ESRD (P = .0006), with a similar pattern observed for the subgroups cid + AA (P = .0126) and idio + AA (P = .0259).
• None of the patients receiving tocilizumab died during the nearly 5-year follow-up period.

IN PRACTICE:

“The data suggest preferential use of IL [interleukin]-1 inhibitors and tocilizumab for clinical use in the treatment of AA amyloidosis depending on the respective underlying diseases,” the authors wrote.

SOURCE:

This study, led by Peter Kvacskay, MD, of Heidelberg University Hospital, Heidelberg, Germany, was published online on April 23 in Annals of the Rheumatic Diseases.

LIMITATIONS:

Authors acknowledged the retrospective nature of the analysis and missing data of single patients during the long-term follow-up as major limitations. Furthermore, the cid + AA subgroup was heterogeneous in terms of the pathophysiology of their underlying primary disease.

DISCLOSURES:

This study did not report any source of funding. The authors declared no conflicts of interest.

A version of this article appeared on Medscape.com.

TOPLINE:

Treatment with biologic disease-modifying antirheumatic drugs (bDMARDs), particularly tocilizumab, can suppress inflammation and preserve renal function in a majority of patients with chronic inflammatory disorders who develop serum amyloid alpha (SAA) amyloidosis.

METHODOLOGY:

• AA amyloidosis, characterized by the misfolding of the SAA protein, is observed in patients with inflammatory diseases and can lead to progressive organ damage, including chronic kidney disease, malabsorption with cachexia, and cardiac failure.
• This monocentric, retrospective analysis assessed the effect of bDMARD therapy on inflammatory biomarker levels and renal outcomes in 83 patients with AA amyloidosis who were followed for a mean period of 4.82 years.
• The patients were stratified into three major subgroups depending on the cause of AA amyloidosis:
• Chronic inflammatory diseases (cid + AA; n = 34) such as rheumatoid arthritis, Crohn’s disease, and chronic infections
• Autoinflammatory syndromes (auto + AA; n = 24) such as familial Mediterranean fever (FMF) and cryopyrin-associated periodic syndrome (CAPS)
• Idiopathic AA (idio + AA; n = 25), wherein the primary disease could not be identified
• Tocilizumab was the most commonly used bDMARD in patients with cid + AA and idio + AA amyloidosis, and interleukin-1 inhibitors were prescribed to patients with auto + AA amyloidosis because tocilizumab has not been approved yet for FMF or CAPS treatment.
• All patients with AA amyloidosis had renal involvement, as confirmed by kidney biopsy.

TAKEAWAY:

• After bDMARD therapy, C-reactive protein levels reduced significantly from baseline to the last-documented visit in all subgroups, while SAA levels declined in the subgroups cid + AA and idio + AA and proteinuria dropped in the subgroups auto + AA and idio + AA.
• bDMARDs prevented progression to end-stage renal disease (ESRD) in 75% of the patients in the overall cohort, with progression to ESRD being prevented in 60% of patients with cid + AA, 88% of patients with auto + AA, and 81% of patients with idio + AA.
• Tocilizumab was more effective than other bDMARDs in preventing renal progression to ESRD (P = .0006), with a similar pattern observed for the subgroups cid + AA (P = .0126) and idio + AA (P = .0259).
• None of the patients receiving tocilizumab died during the nearly 5-year follow-up period.

IN PRACTICE:

“The data suggest preferential use of IL [interleukin]-1 inhibitors and tocilizumab for clinical use in the treatment of AA amyloidosis depending on the respective underlying diseases,” the authors wrote.

SOURCE:

This study, led by Peter Kvacskay, MD, of Heidelberg University Hospital, Heidelberg, Germany, was published online on April 23 in Annals of the Rheumatic Diseases.

LIMITATIONS:

Authors acknowledged the retrospective nature of the analysis and missing data of single patients during the long-term follow-up as major limitations. Furthermore, the cid + AA subgroup was heterogeneous in terms of the pathophysiology of their underlying primary disease.

DISCLOSURES:

This study did not report any source of funding. The authors declared no conflicts of interest.

A version of this article appeared on Medscape.com.

Key clinical point: Red cell distribution width (RDW) and mean platelet volume (MPV) can be used to detect enthesitis in patients with psoriatic arthritis (psoriatic enthesopathy) with musculoskeletal ultrasound scores.

Major finding: There was a significant association between clinical tenderness, presence of enthesophytes on plain radiography, and musculoskeletal ultrasound findings at entheses sites (P < .001 for each). RDW (P = .010) and MPV (P = .001) levels were elevated in patients with psoriatic enthesopathy vs control individuals without the disease, with the hematological indices being positively correlated with disease activity scores (P < .001).

Study details: This case-control study included 30 patients with psoriatic enthesopathy and 20 control individuals without the disease (age > 18 years).

Disclosures: This study received open access funding from The Science, Technology & Innovation Funding Authority in cooperation with The Egyptian Knowledge Bank. The authors declared no conflict of interests.

Source: Amer AS, Al Shambaky AY, Ameen SG, Sobih AK. Hematological indices in psoriatic enthesopathy: Relation to clinical and ultrasound evaluation. Clin Rheumatol. Published online April 8, 2024. Source

Key clinical point: Red cell distribution width (RDW) and mean platelet volume (MPV) can be used to detect enthesitis in patients with psoriatic arthritis (psoriatic enthesopathy) with musculoskeletal ultrasound scores.

Major finding: There was a significant association between clinical tenderness, presence of enthesophytes on plain radiography, and musculoskeletal ultrasound findings at entheses sites (P < .001 for each). RDW (P = .010) and MPV (P = .001) levels were elevated in patients with psoriatic enthesopathy vs control individuals without the disease, with the hematological indices being positively correlated with disease activity scores (P < .001).

Study details: This case-control study included 30 patients with psoriatic enthesopathy and 20 control individuals without the disease (age > 18 years).

Disclosures: This study received open access funding from The Science, Technology & Innovation Funding Authority in cooperation with The Egyptian Knowledge Bank. The authors declared no conflict of interests.

Source: Amer AS, Al Shambaky AY, Ameen SG, Sobih AK. Hematological indices in psoriatic enthesopathy: Relation to clinical and ultrasound evaluation. Clin Rheumatol. Published online April 8, 2024. Source

Key clinical point: Red cell distribution width (RDW) and mean platelet volume (MPV) can be used to detect enthesitis in patients with psoriatic arthritis (psoriatic enthesopathy) with musculoskeletal ultrasound scores.

Major finding: There was a significant association between clinical tenderness, presence of enthesophytes on plain radiography, and musculoskeletal ultrasound findings at entheses sites (P < .001 for each). RDW (P = .010) and MPV (P = .001) levels were elevated in patients with psoriatic enthesopathy vs control individuals without the disease, with the hematological indices being positively correlated with disease activity scores (P < .001).

Study details: This case-control study included 30 patients with psoriatic enthesopathy and 20 control individuals without the disease (age > 18 years).

Disclosures: This study received open access funding from The Science, Technology & Innovation Funding Authority in cooperation with The Egyptian Knowledge Bank. The authors declared no conflict of interests.

Source: Amer AS, Al Shambaky AY, Ameen SG, Sobih AK. Hematological indices in psoriatic enthesopathy: Relation to clinical and ultrasound evaluation. Clin Rheumatol. Published online April 8, 2024. Source

Key clinical point: Ultrasound assessment showed reduced thickness of nail bed and adjacent skin in clinically healthy nails of patients with psoriatic arthritis (PsA) than in control individuals without the disease.

Major finding: Ultrasound identified more morphological changes in the clinically healthy nails of patients with PsA vs control individuals (16.89% vs 3.33%; P = .03), along with significantly lower thickness of nail bed (1.77 mm vs 2.07 mm; P = .027) and adjacent skin (2.26 mm vs 2.59 mm; P = .003). Also, the adjacent skin thickness was positively correlated with tender joint count (correlation coefficient, 0.46; P = .03), suggesting that it can be used as a disease activity indicator.

Study details: This cross-sectional study involved the ultrasound assessment of clinically healthy nails in 22 patients with PsA (219 nails) who were compared with 21 control individuals without PsA (210 nails).

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Mahmoud I, Rouached L, Rahmouni S, et al. Ultrasound assessment of psoriatic arthritis patients with clinically normal nails and evaluation of its correlation with the disease activity: A case-control study. J Ultrasound Med. Published online April 18, 2024. Source

Key clinical point: Ultrasound assessment showed reduced thickness of nail bed and adjacent skin in clinically healthy nails of patients with psoriatic arthritis (PsA) than in control individuals without the disease.

Major finding: Ultrasound identified more morphological changes in the clinically healthy nails of patients with PsA vs control individuals (16.89% vs 3.33%; P = .03), along with significantly lower thickness of nail bed (1.77 mm vs 2.07 mm; P = .027) and adjacent skin (2.26 mm vs 2.59 mm; P = .003). Also, the adjacent skin thickness was positively correlated with tender joint count (correlation coefficient, 0.46; P = .03), suggesting that it can be used as a disease activity indicator.

Study details: This cross-sectional study involved the ultrasound assessment of clinically healthy nails in 22 patients with PsA (219 nails) who were compared with 21 control individuals without PsA (210 nails).

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Mahmoud I, Rouached L, Rahmouni S, et al. Ultrasound assessment of psoriatic arthritis patients with clinically normal nails and evaluation of its correlation with the disease activity: A case-control study. J Ultrasound Med. Published online April 18, 2024. Source

Key clinical point: Ultrasound assessment showed reduced thickness of nail bed and adjacent skin in clinically healthy nails of patients with psoriatic arthritis (PsA) than in control individuals without the disease.

Major finding: Ultrasound identified more morphological changes in the clinically healthy nails of patients with PsA vs control individuals (16.89% vs 3.33%; P = .03), along with significantly lower thickness of nail bed (1.77 mm vs 2.07 mm; P = .027) and adjacent skin (2.26 mm vs 2.59 mm; P = .003). Also, the adjacent skin thickness was positively correlated with tender joint count (correlation coefficient, 0.46; P = .03), suggesting that it can be used as a disease activity indicator.

Study details: This cross-sectional study involved the ultrasound assessment of clinically healthy nails in 22 patients with PsA (219 nails) who were compared with 21 control individuals without PsA (210 nails).

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Mahmoud I, Rouached L, Rahmouni S, et al. Ultrasound assessment of psoriatic arthritis patients with clinically normal nails and evaluation of its correlation with the disease activity: A case-control study. J Ultrasound Med. Published online April 18, 2024. Source

Key clinical point: Bimekizumab demonstrated superior efficacy than placebo and had an acceptable safety profile in patients with psoriatic arthritis (PsA).

Major finding: Bimekizumab vs placebo led to a significantly higher response rate for minimal disease activity (risk ratio [RR], 4.188; P < .001), ≥ 70% improvement in the American College of Rheumatology criteria (RR, 7.932; P < .0001). Bimekizumab was superior to placebo in achieving ACR20/50/70 response at a dose of 160 mg. The risk for treatment-emergent adverse events was modestly higher with bimekizumab vs placebo (RR, 1.423; P = .023), whereas that for serious malignancies, upper respiratory tract infection, injection site reactions, and pharyngitis was similar for both.

Study details: This meta-analysis of four placebo-controlled randomized clinical trials included 1323 patients with PsA (age, ≥ 18 years), of whom 853 received bimekizumab.

Disclosures: This study was supported by the National Science Foundation of China and the Natural Science Foundation of Shanxi Province. The authors declared no conflict of interests.

Source: Su QY, Yang L, Cao TY, et al. Efficacy and safety of bimekizumab in the treatment of psoriatic arthritis: A systematic review and meta-analysis. Expert Opin Drug Saf. Published online April 23, 2024. Source

Key clinical point: Bimekizumab demonstrated superior efficacy than placebo and had an acceptable safety profile in patients with psoriatic arthritis (PsA).

Major finding: Bimekizumab vs placebo led to a significantly higher response rate for minimal disease activity (risk ratio [RR], 4.188; P < .001), ≥ 70% improvement in the American College of Rheumatology criteria (RR, 7.932; P < .0001). Bimekizumab was superior to placebo in achieving ACR20/50/70 response at a dose of 160 mg. The risk for treatment-emergent adverse events was modestly higher with bimekizumab vs placebo (RR, 1.423; P = .023), whereas that for serious malignancies, upper respiratory tract infection, injection site reactions, and pharyngitis was similar for both.

Study details: This meta-analysis of four placebo-controlled randomized clinical trials included 1323 patients with PsA (age, ≥ 18 years), of whom 853 received bimekizumab.

Disclosures: This study was supported by the National Science Foundation of China and the Natural Science Foundation of Shanxi Province. The authors declared no conflict of interests.

Source: Su QY, Yang L, Cao TY, et al. Efficacy and safety of bimekizumab in the treatment of psoriatic arthritis: A systematic review and meta-analysis. Expert Opin Drug Saf. Published online April 23, 2024. Source

Key clinical point: Bimekizumab demonstrated superior efficacy than placebo and had an acceptable safety profile in patients with psoriatic arthritis (PsA).

Major finding: Bimekizumab vs placebo led to a significantly higher response rate for minimal disease activity (risk ratio [RR], 4.188; P < .001), ≥ 70% improvement in the American College of Rheumatology criteria (RR, 7.932; P < .0001). Bimekizumab was superior to placebo in achieving ACR20/50/70 response at a dose of 160 mg. The risk for treatment-emergent adverse events was modestly higher with bimekizumab vs placebo (RR, 1.423; P = .023), whereas that for serious malignancies, upper respiratory tract infection, injection site reactions, and pharyngitis was similar for both.

Study details: This meta-analysis of four placebo-controlled randomized clinical trials included 1323 patients with PsA (age, ≥ 18 years), of whom 853 received bimekizumab.

Disclosures: This study was supported by the National Science Foundation of China and the Natural Science Foundation of Shanxi Province. The authors declared no conflict of interests.

Source: Su QY, Yang L, Cao TY, et al. Efficacy and safety of bimekizumab in the treatment of psoriatic arthritis: A systematic review and meta-analysis. Expert Opin Drug Saf. Published online April 23, 2024. Source

Key clinical point: Eta (14-3-3η) protein could serve as a potential biomarker in the differential diagnosis of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) because patients with PsA showed significantly lower serum levels of eta protein than patients with RA.

Major finding: Eta protein levels were significantly lower in patients with PsA vs RA (regression coefficient [B], −0.341, odds ratio [OR], 0.711; P = .007). A cutoff value of 2.64 ng/mL for eta protein could distinguish between PsA and RA with 54.7% sensitivity and 77.8% specificity (area under the curve, 0.686; P = .001).

Study details: This case-control study included 54 patients with PsA, 53 with RA, and 56 healthy individuals without any rheumatological disease, whose eta protein levels were detected using enzyme-linked immunosorbent assay.

Disclosures: This study was funded by a grant from the Turkish Rheumatology Association. The authors declared no conflict of interests.

Source: Kor A, Orhan K, Maraş Y, et al. Does Eta protein differentiate rheumatoid arthritis from psoriatic arthritis? Curr Med Chem. Published online April 27, 2024. Source

Key clinical point: Eta (14-3-3η) protein could serve as a potential biomarker in the differential diagnosis of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) because patients with PsA showed significantly lower serum levels of eta protein than patients with RA.

Major finding: Eta protein levels were significantly lower in patients with PsA vs RA (regression coefficient [B], −0.341, odds ratio [OR], 0.711; P = .007). A cutoff value of 2.64 ng/mL for eta protein could distinguish between PsA and RA with 54.7% sensitivity and 77.8% specificity (area under the curve, 0.686; P = .001).

Study details: This case-control study included 54 patients with PsA, 53 with RA, and 56 healthy individuals without any rheumatological disease, whose eta protein levels were detected using enzyme-linked immunosorbent assay.

Disclosures: This study was funded by a grant from the Turkish Rheumatology Association. The authors declared no conflict of interests.

Source: Kor A, Orhan K, Maraş Y, et al. Does Eta protein differentiate rheumatoid arthritis from psoriatic arthritis? Curr Med Chem. Published online April 27, 2024. Source

Key clinical point: Eta (14-3-3η) protein could serve as a potential biomarker in the differential diagnosis of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) because patients with PsA showed significantly lower serum levels of eta protein than patients with RA.

Major finding: Eta protein levels were significantly lower in patients with PsA vs RA (regression coefficient [B], −0.341, odds ratio [OR], 0.711; P = .007). A cutoff value of 2.64 ng/mL for eta protein could distinguish between PsA and RA with 54.7% sensitivity and 77.8% specificity (area under the curve, 0.686; P = .001).

Study details: This case-control study included 54 patients with PsA, 53 with RA, and 56 healthy individuals without any rheumatological disease, whose eta protein levels were detected using enzyme-linked immunosorbent assay.

Disclosures: This study was funded by a grant from the Turkish Rheumatology Association. The authors declared no conflict of interests.

Source: Kor A, Orhan K, Maraş Y, et al. Does Eta protein differentiate rheumatoid arthritis from psoriatic arthritis? Curr Med Chem. Published online April 27, 2024. Source

Key clinical point: Real-world study demonstrated that ixekizumab improved disease severity and symptom burden in patients with psoriatic arthritis (PsA).

Major finding: Treatment with ixekizumab led to a significant reduction in the mean overall number of symptoms at the most recent consultation vs baseline (3.4 vs 5.8), tender joint count (2.9 vs 12.3), swollen joint count (3.0 vs 10.3), pain score (2.4 vs 5.7), fatigue score (2.8 vs 5.2), and proportion of patients with severe disease (2% vs 19%; all P < .001), respectively.

Study details: This study used data from the Adelphi PsA Plus Disease Specific Programme (DSP), a cross-sectional survey which included 275 patients with PsA who were prescribed ixekizumab, of whom 55% received ixekizumab as first-line therapy.

Disclosures: The DSP is a wholly owned product of Adelphi Real World. Eli Lilly and Company was a subscriber to the DSP. Eight authors declared being employees or stockowners of Eli Lilly and Company or Adelphi Real World. Several authors declared ties with various sources, including Eli Lilly.

Source: Rohekar S, Vadhariya A, Ross S, et al. Real-world treatment patterns, clinical outcomes, and symptom burden in patients with psoriatic arthritis prescribed ixekizumab in the United States. ACR Open Rheumatol. Published online May 5, 2024. Source

Key clinical point: Real-world study demonstrated that ixekizumab improved disease severity and symptom burden in patients with psoriatic arthritis (PsA).

Major finding: Treatment with ixekizumab led to a significant reduction in the mean overall number of symptoms at the most recent consultation vs baseline (3.4 vs 5.8), tender joint count (2.9 vs 12.3), swollen joint count (3.0 vs 10.3), pain score (2.4 vs 5.7), fatigue score (2.8 vs 5.2), and proportion of patients with severe disease (2% vs 19%; all P < .001), respectively.

Study details: This study used data from the Adelphi PsA Plus Disease Specific Programme (DSP), a cross-sectional survey which included 275 patients with PsA who were prescribed ixekizumab, of whom 55% received ixekizumab as first-line therapy.

Disclosures: The DSP is a wholly owned product of Adelphi Real World. Eli Lilly and Company was a subscriber to the DSP. Eight authors declared being employees or stockowners of Eli Lilly and Company or Adelphi Real World. Several authors declared ties with various sources, including Eli Lilly.

Source: Rohekar S, Vadhariya A, Ross S, et al. Real-world treatment patterns, clinical outcomes, and symptom burden in patients with psoriatic arthritis prescribed ixekizumab in the United States. ACR Open Rheumatol. Published online May 5, 2024. Source

Key clinical point: Real-world study demonstrated that ixekizumab improved disease severity and symptom burden in patients with psoriatic arthritis (PsA).

Major finding: Treatment with ixekizumab led to a significant reduction in the mean overall number of symptoms at the most recent consultation vs baseline (3.4 vs 5.8), tender joint count (2.9 vs 12.3), swollen joint count (3.0 vs 10.3), pain score (2.4 vs 5.7), fatigue score (2.8 vs 5.2), and proportion of patients with severe disease (2% vs 19%; all P < .001), respectively.

Study details: This study used data from the Adelphi PsA Plus Disease Specific Programme (DSP), a cross-sectional survey which included 275 patients with PsA who were prescribed ixekizumab, of whom 55% received ixekizumab as first-line therapy.

Disclosures: The DSP is a wholly owned product of Adelphi Real World. Eli Lilly and Company was a subscriber to the DSP. Eight authors declared being employees or stockowners of Eli Lilly and Company or Adelphi Real World. Several authors declared ties with various sources, including Eli Lilly.

Source: Rohekar S, Vadhariya A, Ross S, et al. Real-world treatment patterns, clinical outcomes, and symptom burden in patients with psoriatic arthritis prescribed ixekizumab in the United States. ACR Open Rheumatol. Published online May 5, 2024. Source

Key clinical point: Guselkumab treatment for 4 months was effective in patients with psoriatic arthritis (PsA) who had inflammatory back pain associated with suggestive axial involvement assessed by MRI or X-ray.

Major finding: At 4 months, the Bath Ankylosing Spondylitis Disease Activity Index scores reduced significantly in patients receiving guselkumab (mean difference, −2.11 ± 0.43; P < .05), with nearly half of the patients achieving a BASDAI score ≤ 4. Similar outcomes were observed in terms of Ankylosing Spondylitis Disease Activity Scores (P = .021) and Disease Activity in PsA scores (P = .001).

Study details: Findings are from a real-life, multicenter study including 67 patients with PsA and suggestive features of axial involvement as shown by x-ray or MRI who were treated with guselkumab for ≥ 4 months.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Ruscitti P, Pantano I, Cataldi G, et al. Short-term effectiveness of guselkumab in psoriatic arthritis patients and suggestive features of axial involvement: Results from a real-life multicentre cohort. Rheumatology (Oxford). Published online April 10, 2024. Source

Key clinical point: Guselkumab treatment for 4 months was effective in patients with psoriatic arthritis (PsA) who had inflammatory back pain associated with suggestive axial involvement assessed by MRI or X-ray.

Major finding: At 4 months, the Bath Ankylosing Spondylitis Disease Activity Index scores reduced significantly in patients receiving guselkumab (mean difference, −2.11 ± 0.43; P < .05), with nearly half of the patients achieving a BASDAI score ≤ 4. Similar outcomes were observed in terms of Ankylosing Spondylitis Disease Activity Scores (P = .021) and Disease Activity in PsA scores (P = .001).

Study details: Findings are from a real-life, multicenter study including 67 patients with PsA and suggestive features of axial involvement as shown by x-ray or MRI who were treated with guselkumab for ≥ 4 months.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Ruscitti P, Pantano I, Cataldi G, et al. Short-term effectiveness of guselkumab in psoriatic arthritis patients and suggestive features of axial involvement: Results from a real-life multicentre cohort. Rheumatology (Oxford). Published online April 10, 2024. Source

Key clinical point: Guselkumab treatment for 4 months was effective in patients with psoriatic arthritis (PsA) who had inflammatory back pain associated with suggestive axial involvement assessed by MRI or X-ray.

Major finding: At 4 months, the Bath Ankylosing Spondylitis Disease Activity Index scores reduced significantly in patients receiving guselkumab (mean difference, −2.11 ± 0.43; P < .05), with nearly half of the patients achieving a BASDAI score ≤ 4. Similar outcomes were observed in terms of Ankylosing Spondylitis Disease Activity Scores (P = .021) and Disease Activity in PsA scores (P = .001).

Study details: Findings are from a real-life, multicenter study including 67 patients with PsA and suggestive features of axial involvement as shown by x-ray or MRI who were treated with guselkumab for ≥ 4 months.

Disclosures: This study did not receive any funding. The authors declared no conflict of interests.

Source: Ruscitti P, Pantano I, Cataldi G, et al. Short-term effectiveness of guselkumab in psoriatic arthritis patients and suggestive features of axial involvement: Results from a real-life multicentre cohort. Rheumatology (Oxford). Published online April 10, 2024. Source

Key clinical point: Risk factors for psoriasis developing into clinical psoriatic arthritis (PsA) include higher age, nail involvement, increased erythrocyte sedimentation rate (ESR), and elevated high-sensitivity C-reactive protein (hs-CRP) levels.

Major finding: Age ≥ 40 years (odds ratio [OR], 1.04; P < .01), nail involvement (OR, 1.17; P < .01), increased ESR (OR, 1.03; P < .05), and elevated hs-CRP levels (OR, 1.31; P < .01) increased the risk for incident PsA in patients with psoriasis. Moreover, MRI-detected enthesitis and tenosynovitis combined with these risk factors vs the risk factors alone showed better specificity (94.3% vs 69.0%) and similar sensitivity (89.0% vs 84.6%) in diagnosing PsA.

Study details: This longitudinal case-control study included 75 patients diagnosed with clinical PsA who were compared with 345 patients with psoriasis and without PsA, all of whom were aged 18-65 years.

Disclosures: This study was supported by the Beijing Municipal Science and Technology Project. The authors declared no conflict of interests.

Source: Yao A, Wang L, Qi F, et al. Risk factors and early detection of joint damage in patients with psoriasis: A case–control study. Int J Dermatol. Published online April 29, 2024. Source

Key clinical point: Risk factors for psoriasis developing into clinical psoriatic arthritis (PsA) include higher age, nail involvement, increased erythrocyte sedimentation rate (ESR), and elevated high-sensitivity C-reactive protein (hs-CRP) levels.

Major finding: Age ≥ 40 years (odds ratio [OR], 1.04; P < .01), nail involvement (OR, 1.17; P < .01), increased ESR (OR, 1.03; P < .05), and elevated hs-CRP levels (OR, 1.31; P < .01) increased the risk for incident PsA in patients with psoriasis. Moreover, MRI-detected enthesitis and tenosynovitis combined with these risk factors vs the risk factors alone showed better specificity (94.3% vs 69.0%) and similar sensitivity (89.0% vs 84.6%) in diagnosing PsA.

Study details: This longitudinal case-control study included 75 patients diagnosed with clinical PsA who were compared with 345 patients with psoriasis and without PsA, all of whom were aged 18-65 years.

Disclosures: This study was supported by the Beijing Municipal Science and Technology Project. The authors declared no conflict of interests.

Source: Yao A, Wang L, Qi F, et al. Risk factors and early detection of joint damage in patients with psoriasis: A case–control study. Int J Dermatol. Published online April 29, 2024. Source

Key clinical point: Risk factors for psoriasis developing into clinical psoriatic arthritis (PsA) include higher age, nail involvement, increased erythrocyte sedimentation rate (ESR), and elevated high-sensitivity C-reactive protein (hs-CRP) levels.

Major finding: Age ≥ 40 years (odds ratio [OR], 1.04; P < .01), nail involvement (OR, 1.17; P < .01), increased ESR (OR, 1.03; P < .05), and elevated hs-CRP levels (OR, 1.31; P < .01) increased the risk for incident PsA in patients with psoriasis. Moreover, MRI-detected enthesitis and tenosynovitis combined with these risk factors vs the risk factors alone showed better specificity (94.3% vs 69.0%) and similar sensitivity (89.0% vs 84.6%) in diagnosing PsA.

Study details: This longitudinal case-control study included 75 patients diagnosed with clinical PsA who were compared with 345 patients with psoriasis and without PsA, all of whom were aged 18-65 years.

Disclosures: This study was supported by the Beijing Municipal Science and Technology Project. The authors declared no conflict of interests.

Source: Yao A, Wang L, Qi F, et al. Risk factors and early detection of joint damage in patients with psoriasis: A case–control study. Int J Dermatol. Published online April 29, 2024. Source

Key clinical point: Patients with psoriasis who had subclinical psoriatic arthritis (PsA) based on the presence of arthralgia had a higher likelihood of developing PsA than those with only psoriasis.

Major finding: At a mean follow-up of 33 months, 80.9% of patients had subclinical PsA, with the incidence rate of new-onset PsA being 7.7 per 100 patients-years in this group and the most predominant presentation being peripheral arthritis (82.1%). The risk of developing PsA was significantly higher in patients with subclinical PsA vs psoriasis (hazard ratio, 11.7; P = .016).

Study details: This study included 384 patients with psoriasis from two European cohorts of whom 56 patients developed new-onset PsA.

Disclosures: This study did not disclose any specific funding. Six authors declared being consultants for or having other ties with various sources. The other authors declared no conflict of interests.

Source: Zabotti A, Fagni F, Gossec L, et al. Risk of developing psoriatic arthritis in psoriasis cohorts with arthralgia: Exploring the subclinical psoriatic arthritis stage. RMD Open. 2024;10:e004314. Source

Key clinical point: Patients with psoriasis who had subclinical psoriatic arthritis (PsA) based on the presence of arthralgia had a higher likelihood of developing PsA than those with only psoriasis.

Major finding: At a mean follow-up of 33 months, 80.9% of patients had subclinical PsA, with the incidence rate of new-onset PsA being 7.7 per 100 patients-years in this group and the most predominant presentation being peripheral arthritis (82.1%). The risk of developing PsA was significantly higher in patients with subclinical PsA vs psoriasis (hazard ratio, 11.7; P = .016).

Study details: This study included 384 patients with psoriasis from two European cohorts of whom 56 patients developed new-onset PsA.

Disclosures: This study did not disclose any specific funding. Six authors declared being consultants for or having other ties with various sources. The other authors declared no conflict of interests.

Source: Zabotti A, Fagni F, Gossec L, et al. Risk of developing psoriatic arthritis in psoriasis cohorts with arthralgia: Exploring the subclinical psoriatic arthritis stage. RMD Open. 2024;10:e004314. Source

Key clinical point: Patients with psoriasis who had subclinical psoriatic arthritis (PsA) based on the presence of arthralgia had a higher likelihood of developing PsA than those with only psoriasis.

Major finding: At a mean follow-up of 33 months, 80.9% of patients had subclinical PsA, with the incidence rate of new-onset PsA being 7.7 per 100 patients-years in this group and the most predominant presentation being peripheral arthritis (82.1%). The risk of developing PsA was significantly higher in patients with subclinical PsA vs psoriasis (hazard ratio, 11.7; P = .016).

Study details: This study included 384 patients with psoriasis from two European cohorts of whom 56 patients developed new-onset PsA.

Disclosures: This study did not disclose any specific funding. Six authors declared being consultants for or having other ties with various sources. The other authors declared no conflict of interests.

Source: Zabotti A, Fagni F, Gossec L, et al. Risk of developing psoriatic arthritis in psoriasis cohorts with arthralgia: Exploring the subclinical psoriatic arthritis stage. RMD Open. 2024;10:e004314. Source

Key clinical point: Risankizumab showed consistent long-term efficacy in patients with active psoriatic arthritis (PsA) regardless of baseline demographic, disease characteristics, and prior medication use.

Major finding: At week 24, a higher number of patients receiving risankizumab vs placebo achieved ≥ 20% improvement in the American College of Rheumatology response (ACR20; 46.3%-60.1% vs 15.5%-36.2%) despite varying demographic and disease characteristics. At week 52, similar proportions of patients who were randomized to risankizumab (48.6%-75.8%) or who switched from placebo to risankizumab (43.7%-63.9%) achieved ACR20.

Study details: This post hoc integrated analysis of the phase 3 KEEPsAKE 1 and KEEPsAKE 2 trials included 1235 patients with active PsA and prior inadequate response or intolerance to conventional synthetic or biologic disease-modifying antirheumatic drugs who received risankizumab or placebo with crossover to risankizumab at week 24.

Disclosures: This study was funded by AbbVie. Four authors declared being employees of and holding stocks or stock options with AbbVie. The other authors declared having ties with AbbVie and various sources.

Source: Merola JF, Armstrong A, Khattri S, et al. Efficacy of risankizumab across subgroups in patients with active psoriatic arthritis: A post hoc integrated analysis of the phase 3 KEEPsAKE 1 and KEEPsAKE 2 randomized controlled trials. J Dermatolog Treat. 2024;35:2342383. Source

Key clinical point: Risankizumab showed consistent long-term efficacy in patients with active psoriatic arthritis (PsA) regardless of baseline demographic, disease characteristics, and prior medication use.

Major finding: At week 24, a higher number of patients receiving risankizumab vs placebo achieved ≥ 20% improvement in the American College of Rheumatology response (ACR20; 46.3%-60.1% vs 15.5%-36.2%) despite varying demographic and disease characteristics. At week 52, similar proportions of patients who were randomized to risankizumab (48.6%-75.8%) or who switched from placebo to risankizumab (43.7%-63.9%) achieved ACR20.

Study details: This post hoc integrated analysis of the phase 3 KEEPsAKE 1 and KEEPsAKE 2 trials included 1235 patients with active PsA and prior inadequate response or intolerance to conventional synthetic or biologic disease-modifying antirheumatic drugs who received risankizumab or placebo with crossover to risankizumab at week 24.

Disclosures: This study was funded by AbbVie. Four authors declared being employees of and holding stocks or stock options with AbbVie. The other authors declared having ties with AbbVie and various sources.

Source: Merola JF, Armstrong A, Khattri S, et al. Efficacy of risankizumab across subgroups in patients with active psoriatic arthritis: A post hoc integrated analysis of the phase 3 KEEPsAKE 1 and KEEPsAKE 2 randomized controlled trials. J Dermatolog Treat. 2024;35:2342383. Source

Key clinical point: Risankizumab showed consistent long-term efficacy in patients with active psoriatic arthritis (PsA) regardless of baseline demographic, disease characteristics, and prior medication use.

Major finding: At week 24, a higher number of patients receiving risankizumab vs placebo achieved ≥ 20% improvement in the American College of Rheumatology response (ACR20; 46.3%-60.1% vs 15.5%-36.2%) despite varying demographic and disease characteristics. At week 52, similar proportions of patients who were randomized to risankizumab (48.6%-75.8%) or who switched from placebo to risankizumab (43.7%-63.9%) achieved ACR20.

Study details: This post hoc integrated analysis of the phase 3 KEEPsAKE 1 and KEEPsAKE 2 trials included 1235 patients with active PsA and prior inadequate response or intolerance to conventional synthetic or biologic disease-modifying antirheumatic drugs who received risankizumab or placebo with crossover to risankizumab at week 24.

Disclosures: This study was funded by AbbVie. Four authors declared being employees of and holding stocks or stock options with AbbVie. The other authors declared having ties with AbbVie and various sources.

Source: Merola JF, Armstrong A, Khattri S, et al. Efficacy of risankizumab across subgroups in patients with active psoriatic arthritis: A post hoc integrated analysis of the phase 3 KEEPsAKE 1 and KEEPsAKE 2 randomized controlled trials. J Dermatolog Treat. 2024;35:2342383. Source